People with diabetes or prediabetes are responsible for much of their care, which can be a daunting process. However, self-care can be made easier by setting diabetes goals for blood sugar levels, weight loss, exercise and for control of other health risks.

Diabetes Blood Sugar Goals

The International Diabetes Center in Minneapolis, Minn., suggests setting blood sugar targets for people with prediabetes and diabetes, as measured in milligrams per deciliter (mg/dL). The target ranges, summarized on the federal government's National Guideline Clearinghouse Web site, are as follows:

• Before a meal: 70 mg/dL to 140 mg/dL
• Two hours after eating: Less than 160 mg/dL
• At bedtime: 100 mg/dL to 160 mg/dL
• Hemoglobin A1c level: Less than 1% higher than the lab's normal glucose value

It also suggests that more than half of a person's self-administered blood sugar tests be within the targeted range and that he or she have no nighttime low blood sugars or any low blood sugars that require intervention.

However, these general targets may need to be adapted specifically for individuals, says Sandra Krafsig, a registered nurse and certified diabetes educator at Marlborough Hospital in Massachusetts. "The goals may vary depending on other risk factors, such as age, cardiac disease and other complications."

Diabetes Weight Goals

Being overweight is itself a risk for diabetes. In addition, excess weight can make it harder for the body to use insulin. Most healthcare professionals suggest that diabetics aim for a healthy weight for their height and body type. This number is often based on a person's body mass index (between 18.5 and 24.9 is considered healthy), waist circumference (less than 40 inches for men; less than 35 for women) and frame.

If a woman is pregnant, her healthcare provider may set guidelines for how much weight she should aim to gain during her pregnancy, depending on her prepregnancy weight and whether she has gestational diabetes. These guidelines generally are:

• Three to six pounds for the first three months of pregnancy
• Between one half and one pound each week for the last six months of pregnancy

Diabetes Cardiac Goals

The National Institutes of Health also sets target ranges for blood pressure and lipid levels, since each of those can contribute to the risk of heart disease:

• Blood pressure: Less than 130/80
• Low-density lipoprotein (LDL or "bad" cholesterol): Less than 100 mg/dL;
• High-density lipoprotein (HDL or "good" cholesterol): Greater than 40 mg/dL for men and greater than 50 for women
• Triglycerides: Less than 150 mg/dL

Achieving Your Diabetes Goals

Goal-setting should be a joint effort between a patient and his healthcare team, according to Theresa Garnero, an advanced practice registered nurse and certified diabetes educator. "Our job is to follow the patient's agenda. Of course, we have our own agenda, but that won't do any good if the patient isn't ready for it," says Garnero.

David Spero, also a registered nurse and author of "Diabetes: Sugar-coated Crisis," agrees. He says that it's best for a person to start with small changes that can act as steps toward achieving his or her overall goals.

"Choose something that you want to do and something you reasonably can do," says Spero. "Start with small changes and build up."

He also suggests that people with diabetes set themselves up to reach their goals. Before setting a target, they should ask themselves how confident they are that they can achieve it.

"You might also want to list reasons why making the change is important to you," says Spero. "List the barriers that might get in your way and come up with ways of how you might overcome them." He suggests that support from family, a friend or another person with diabetes can be helpful.

Spero says that one of the biggest ways to achieve goals is to begin with change. "Change something in life that damages you," he says. It can be that morning doughnut or a lack of physical activity. "No matter how small that change is, any successful change builds your self-confidence and makes the next change easier."

Garnero is a strong believer in humor's ability to help achieve goals. She was named diabetes educator of the year in 2004 by the American Diabetes Association, and much of her work is in the form of cartoons. "This is a serious disease," she says. "Ninety-five percent of managing diabetes is self-care. That adds stress and stress wreaks havoc with blood sugars. But if you can remember to laugh, you can ease some of the stress."

Sources:

Clarke, MD, Charles M., Judith E. Fradkin, MD, Roland G. Hiss, MD, Rodney A. Lorenz, MD, Frank Vinicor, MD, MPH5 and Elizabeth Warren-Boulton, RN, MSN. "The National Diabetes Education Program, Changing the Way Diabetes Is Treated." Diabetes Care. 24(2001): 617-618.

International Diabetes Center. "Type 2 Diabetes Practice Guidelines." Minneapolis: International Diabetes Center, 2003.

Krafsig, Sandra. E-mail interview. 29 Aug. 2007.

"What Should I Do If I Have Gestational Diabetes?" National Institute of Child Health & Human Development. 16 Aug. 2006. National Institutes of Health. 23 Aug. 2007.

Spero, David. E-mail interview. 22 Aug 2007.

"What Diabetes Is." National Diabetes Informaton Clearinghouse. Oct. 2006. National Institute of Diabetes and Digestive and Kidney Diseases. 1 Sep. 2007.